Consensus position statement on emerging treatments in dermatology by the Association of Cutaneous Surgeons of India Task Force

Introduction: Emerging treatments in dermatology are often introduced into clinical practice due to the hype and publicity they carry. Dermatologists are often tempted to introduce these treatments which lack clinical evidence pertaining to safety and efficacy. This consensus position statement is presented to make dermatologists aware of the efficacy and safety, recommending the present status of six emerging treatments in dermatology, namely exosomes, polydeoxyribonucleotides (PDRNs), autologous micrograft transplant using Rigenera Activa ™ device, nanofat and stromal vascular fraction (SVF) for androgenetic alopecia, intravenous (IV) therapy, and thread lifts. It has been conducted by the Task Force of the Association of Cutaneous Surgeons of India (ACSI). Background and Aim: Emerging treatments in dermatology gain immense traction due to their prominence on social media and peer usage. Most of these treatments are unregulated, unapproved, with unknown long term-safety data. Many also have questionable efficacy with no standard protocols for use. This study consensus was thus conceived to find current clinical evidence, identify gaps, and provide a guideline to dermatologists while using these treatments. Material and Methods: Sixteen dermatologists of the Task Force of ACSI divided into groups of two and three, researched evidence for efficacy, guidelines for use, and safety from published literature. Six emerging treatments in dermatology, namely exosomes, PDRN, autologous micrograft transplant using Rigenera Activa TM device, nanofat and stromal vascular fraction (SVF) for androgenetic alopecia, IV therapy, and thread lifts were included. The expert panel developed a consensus statement deducing the level of evidence, strength of recommendation grade, and safety of the six treatments, using a modified Delphi consensus method. The final consensus was arrived at if >90% fully agreed to the recommendations. Less than a 90% consensus on a particular treatment was deliberated upon in a second round, asking the concerned expert to provide a reasoning and a re-evaluation was done. Results: Out of the 14 dermatologists, over 90% fully agreed to the strengths of recommendation, levels of evidence, and safety recommendations of all the six emerging treatments. The final consensus was thus arrived at.